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About 1 in 3 adults in the U.S. has high blood pressure, but many don’t realize it. High blood pressure is sometimes called a “silent killer,” because it usually has no warning signs, yet it can lead to life-threatening conditions like heart attack or stroke. The good news is that high blood pressure, or hypertension, can often be prevented or treated. Early diagnosis and simple, healthy changes can keep high blood pressure from seriously damaging your health.

Normal blood flow delivers nutrients and oxygen to all parts of your body, including important organs like your heart, brain, and kidneys. Your beating heart helps to push blood through your vast network of blood vessels, both large and small. Your blood vessels, in turn, constantly adjust. They become narrower or wider to maintain your blood pressure and keep blood flowing at a healthy rate.

It’s normal for your blood pressure to go up and down throughout each day. Blood pressure is affected by time of day, exercise, the foods you eat, stress, and other factors. Problems can arise, though, if your blood pressure stays too high for too long.

High blood pressure can make your heart work too hard and lose strength. The high force of blood flow can damage your blood vessels, making them weak, stiff, or narrower. Over time, hypertension can harm several important organs, including your heart, kidneys, brain, and eyes.

“Hypertension is a leading risk factor for death and disability worldwide,” says Dr. Paul Whelton, an expert in hypertension and kidney disease at Tulane University. “High blood pressure raises the risk of having a heart attack, heart failure, stroke, or kidney disease.”

Anyone, even children, can develop high blood pressure. But the risk for hypertension rises with age. “Once people are in their 60s, about two-thirds of the population is affected by hypertension,” Whelton says.

Excess weight or having a family history of high blood pressure also raises your risk for hypertension.

African Americans are especially likely to get hypertension. Compared to Caucasian or Hispanic American adults, African Americans tend to develop hypertension at a younger age and to have a higher blood pressure on average.

Because it usually has no symptoms, the only way to know for sure that you have hypertension is to have a blood pressure test. This easy, painless test involves placing an inflated cuff with a pressure gauge around your upper arm to squeeze the blood vessels. A health care provider may then use a stethoscope to listen to your pulse as air is released from the cuff, or an automatic device may measure the pressure.

Blood pressure is given as 2 numbers. The first number represents the pressure in your blood vessels as the heart beats (called systolic pressure). The second is the pressure as your heart relaxes and fills with blood (diastolic pressure). Experts generally agree that the safest blood pressure—or “normal” blood pressure—is 120/80 or lower, meaning systolic blood pressure is 120 or less and diastolic pressure is 80 or less.

“Hypertension is defined as having an average blood pressure of above 140/90,” says NIH’s Dr. Lawrence Fine, who oversees research on the treatment and prevention of hypertension. Since blood pressure can vary widely from day to day, a diagnosis of hypertension is usually based on an average of 2 or more readings taken on 2 or more occasions.

If your blood pressure falls between “normal” and “hypertension,” it’s sometimes called prehypertension. People with prehypertension are more likely to end up with high blood pressure if they don’t take steps to prevent it.

“We know we can prevent high blood pressure through diet, weight loss, and physical activity,” Whelton says. “We can also treat it, and we can treat it effectively.”

If you’re diagnosed with high blood pressure, your doctor will prescribe a treatment plan. You’ll likely be advised to make healthy lifestyle changes (see the Wise Choices box). You may also need to take medications. The goal of treatment is to reduce your blood pressure enough to avoid more serious problems.

How low should you aim when reducing your blood pressure? The answer depends on many factors, which is why it’s important to work with your doctor on blood pressure goals. Most current guidelines recommend aiming for a systolic pressure below 140. These medical guidelines are sometimes adjusted as new research is reported.

A large NIH-funded study recently found there may be benefits to aiming for a much lower systolic pressure—120 or less, instead of 140—at least for some people. The study looked at adults ages 50 and up who had increased risk for cardiovascular disease but didn’t have diabetes. Half aimed for a systolic pressure of 120. The rest aimed for a pressure of 140.

The study was stopped early, after about 3 years, when clear benefits were seen in the lower blood pressure group. “When treating to the lower goal of 120, the risk of having a cardiovascular complication such as a heart attack or stroke was reduced by 25%, and the risk of death from all causes was reduced by 27%,” Fine says. This lower-goal group, though, tended to need 1 additional blood pressure medication; they also had more hospitalizations for side effects, including low blood pressure, fainting, and possible kidney damage.

“Results to date suggest that for older people with hypertension and an increased risk for cardiovascular disease, it may make sense to aim for a lower blood pressure. But there may be drawbacks as well, and each patient is different,” Whelton says. “Researchers generate the evidence, so health care providers can have informed discussions with their patients about blood pressure targets.”

NIH-funded studies have clearly shown that healthy lifestyle changes can improve your blood pressure. “Making even small changes over time can really add up,” says Kathryn McMurry, a nutrition science expert at NIH. “In terms of diet, our best advice is to follow the DASH eating plan.”

DASH stands for Dietary Approaches to Stop Hypertension. “It’s not a diet to go on for a short period of time, but one that’s meant to be part of a healthy lifestyle and enjoyed for life,” McMurry says.

The DASH eating plan requires no special foods. Instead, it provides daily and weekly nutritional goals. It’s high in vegetables, fruit, whole grains, and low-fat dairy foods but low in saturated fat and added sugar.

“DASH is beneficial even for people who have normal blood pressure or who have prehypertension. It can help keep blood pressure from progressing to higher levels,” McMurry says. Learn more about DASH atwww.nhlbi.nih.gov/health/health-topics/topics/dash.

Get a good night’s sleep. Tell your doctor if you’ve been told you snore or sound like you stop breathing briefly when you sleep—a possible sign of sleep apnea. Treating sleep apnea and getting a good night’s sleep can help reduce blood pressure.

Take prescribed medications as directed. If you need drugs to help lower your blood pressure, you still should follow the lifestyle changes described above.

This vegetarian hot-&-sour-inspired soup is chock-full of tofu and vegetables, plus noodles to make it hearty enough for dinner.

Makes: 8 servings, about 2 cups each

Active Time: 30 minutes

Total Time: Slow-cooker time: 4-8 hours

Ingredients

24 dried shiitake or black Chinese mushrooms (2-3 ounces)

2 carrots, cut into 1/2-by-2-inch sticks

2 8-ounce cans bamboo shoots, rinsed

2 14-ounce packages extra-firm water-packed tofu, drained

1 teaspoon ground white pepper

4 cups thinly sliced green cabbage

4 1/3 cups water, divided

4 cups mushroom or vegetable broth

1/4 cup white vinegar or rice vinegar

1/4 cup red-wine vinegar

1/4 cup reduced-sodium soy sauce, plus more to taste

1 tablespoon chile-garlic sauce (see Tip), plus more to taste

1 tablespoon minced fresh ginger

3 tablespoons cornstarch

1 tablespoon toasted sesame oil

3 cups cooked lo mein noodles (about 6 ounces dry)

1 cup sliced scallions

Preparation

Discard mushroom stems and cut the caps into 1/2-inch pieces. Spread the mushroom pieces in a 6-quart or larger slow cooker. Add carrots and bamboo shoots. Cut tofu into 1/2-inch pieces, add to slow cooker and sprinkle with white pepper. Top with cabbage.

Whisk the remaining 1/3 cup water, cornstarch and sesame oil in a bowl. Stir into the soup. Cover and cook on High for 20 minutes. Stir in noodles, cover and heat through for 10 minutes. Serve topped with scallions and with more soy sauce and chile-garlic sauce, if desired.

10 Heat-Beating Tips

If possible, stay out of the sun. When in the sun, wear lightweight, light colored, loose fitting clothing that covers as much of your skin as possible. Consider a hat to protect your face and head.

Use an air conditioner if you have one.

If you do not have an air conditioner, keep rooms well-ventilated with open windows and fans. Consider spending the warmest part of the day in a public building such as a library, store, mall, movie theater or find a local pool.

Stay hydrated. Drink plenty of fluids – particularly water – even if you do not feel thirsty. Avoid beverages containing alcohol, caffeine, or high amounts of sugar.

Eat light well balanced meals and avoid hot or spicy foods.

Avoid strenuous activity, especially during the hottest hours of the day – usually 11 AM to 4 PM. If you must engage in outdoor activities, rest often and plan them for the early morning and evening. Work or rest in the shade when possible.

Cool showers or baths may be helpful, but avoid extreme temperature changes. Never take a shower immediately after becoming overheated – extreme temperature changes may make you ill, nauseated, or dizzy.

Never leave children, pets, or those who require special care in a parked car during periods of intense summer heat.

People taking medicines for high blood pressure, depression, poor circulation (water pills) may be more susceptible to heat related illnesses

Make a special effort to check on your neighbors during a heat wave, especially if they are seniors, young children, and people with special needs.

Heat-related deaths and illness are preventable yet every year many people succumb to extreme heat. People suffer heat-related illness when their bodies are unable to compensate and properly cool themselves. The body normally cools itself by sweating. But under some conditions, sweating just isn’t enough. In such cases, a person’s body temperature rises rapidly.

Several factors affect the body’s ability to cool itself during extremely hot weather. When the humidity is high, sweat will not evaporate as quickly, preventing the body from releasing heat. Other conditions such as age, obesity, fever, dehydration, heart disease, mental illness, poor circulation, sunburn, and prescription drug and alcohol use can contribute to heat-related illness.

HEAT CRAMPS:

Heat cramps are muscular pains and spasms, usually in the legs arms or abdomen, resulting from exertion during extreme heat that causes copious sweating. This sweating depletes the body’s salt and hydration. Heat cramps usually occur when the heat index is between 90 and 105 degrees. Although heat cramps are the least severe of all heat-related health problems, they are often the first signal that the body is having trouble coping with the heat and should be treated immediately with rest and fluids. Drink clear juice or a sports drink to help ease the cramps. Stretching, gentle massaging of the muscle or direct, firm pressure on cramps can reduce pain. Seek medical attention if pain is severe, lasts longer than an hour or nausea occurs.

HEAT EXHAUSTION:

Heat exhaustion is a moderate form of heat-related illness. It can develop after several days of exposure to high temperatures and inadequate fluid consumption or when body fluids are lost through heavy sweating due to vigorous exercise or working in a hot, humid place. Blood flow to the skin increases, causing blood flow to vital organs to decrease. Symptoms include: heavy sweating, pale and clammy skin, weakness, fatigue, headache, nausea or vomiting, dizziness, fast shallow breaths, and a fast weak pulse.

Heat exhaustion should be treated with rest in a cool area, sipping cool water or sports drinks, elevating the feet several inches, and apply cool cloths for the face, neck, hands, feet and arm pits. Seek further medical treatment in severe cases or if the symptoms do not improve after an hour. If not treated, the victim’s condition may escalate to heat stroke.

HEAT STROKE:

Heat stroke — also called “sunstroke” — occurs when a person’s body is unable to regulate it’s temperature. The body’s temperature rises rapidly sweating ceases and the body is unable to cool down. The skin is flushed, red, hot and dry. A person’s temperature will be very high (above 103 degrees orally). Other warning signs may include headache, dizziness, nausea, confusion, seizures or unconsciousness. In fact, body temperature can rise so high that brain damage and death may result if the body is not cooled quickly.

Heat stroke is the most serious heat-related illness and requires immediate emergency medical attention. While waiting on the Ambulance crew to arrive, begin cooling the victim. Move the victim to a cool or shaded area. Cool the person quickly using a cool bath, shower, spay from a garden hose or wrap them in a damp sheet. If possible, monitor the person’s temperature until help arrives. Heat stroke usually occurs when the heat index is 130 degrees or higher.

With warm weather and family gatherings, the Fourth of July can be a great time to celebrate and make memories. Fireworks are also a great way to celebrate, but fireworks can cause severe burns and eye injuries If not handled properly. To help you celebrate this Fourth of July, we have compiled the following safety tips:

Some fireworks are illegal in Pennsylvania so be sure to buy from reputable sellers.

Always read and follow label directions.

Children should never play with fireworks. Even sparklers are dangerous. They can get hot enough to melt gold and will burn skin, clothing and hair.

Only use outdoors.

Always have water handy (a garden hose and a bucket).

Light only one firework at a time and do not alter or bundle fireworks together.

Never throw or point fireworks at people, animals, or flammable items.

Do not carry fireworks in your pocket.

Never shoot fireworks from your hand or in metal or glass containers.

Do not re-light a “dud” firework (wait 15 to 20 minutes and then soak it in a bucket of water).

If necessary, store fireworks in a cool, dry place.

Dispose of fireworks properly by soaking them in water and then disposing of them in your trashcan.

The shooter should always wear eye protection and never have any part of the body over the firework.

Alcohol and fireworks do not mix. Even a small amount of alcohol can impair one’s judgment and ability to properly set up and set off fireworks.

And by now you must have heard that smaller plates lead to smaller portions. Have you ever wondered if it is true? Well, a group of Belgian researchers conducted a small study recently where they offered college students M&M candies. Each of the students watched a 22 minute television show and were given a bowl of M&Ms. The first group was given 7 ounces of candy in a one-cup bowl.

The second group was given the same 7 ounces of candy in a larger three-cup bowl. Finally the third group was given a three-cup bowl of candy filled with 21 ounces of candy. The results? Well, the students ate twice as much candy from the large bowls (2 ounces more for about 300 extra calories) that they did from the small bowl.

So, what to do? Consider using or even buying smaller dishes. Your health and waistline may be worth the investment. Also, repackage food from larger containers with multiple servings into single portions. And when dining out, cut your dinner in half as soon as it arrives at the table and have your server wrap it to go. Not only do you save the calories, but you also get a second meal for later.

The idea of using bacteria to improve your health may seem odd, but it has been around since the early 1900s. However, not until just recently did people really begin to embrace the concept. Today, probiotic and prebiotic products are safe, effective, and widely used to treat and prevent gastrointestinal conditions.

Good Bacteria

Your body contains billions of bacteria that help you stay healthy. The largest population of bacteria can be found in your intestines. These beneficial bacteria help you digest food, and absorb nutrients. If the bacteria in your intestines is disrupted you may experience digestive difficulties and gastrointestinal symptoms. In order to re-establish healthy intestinal bacteria you can take probiotic or prebiotic supplements. While they sound similar and work in the same body system they are different.

Probiotics

Probiotics are generally live bacteria that live in your intestines. These microorganisms can positively impact your health. You can find probiotics in many food products, including yoghurt and sauerkraut. Probiotics can also be found in supplements. These supplements contain bacteria that are well-studied strains that have been specially prepared to survive the journey through the stomach into the intestines where they can grow.

Prebiotics

Prebiotics are substances that encourage the growth of beneficial bacteria—think of prebiotics as the food for probiotics. Prebiotics are non-living and mostly comprised of non-digestible carbohydrates from fruits and grains. Prebiotics can encourage the growth of beneficial bacteria already living in the body and also aid in the growth and maintenance of probiotics.